Chylothorax following oesophagogastrectomy for malignant disease

Alexiou, Christos; Watson, Michael; Beggs, David; Salama, F D; Morgan, William E.

doi:10.1016/s1010-7940(98)00230-9

Cited by 77 publications

(59 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…If chyle is not stopped, patients will faced immune deficiency, resulting in infection and mortality (35). Some studies have shown the superiority of surgery over conservative treatment (34,(38)(39)(40). Thus, the treatment method of Chylothorax is conservative but when the outlet of the chest tube is more than 800 cc per day and it will continue for 4 to 5 consecutive days, waiting for stopping the leak may be dangerous due to leukopenia and malnutrition; therefore, surgery is required in these circumstances.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Early and Late Complications in Three Esophagectomy Techniques

Mousavi¹,

Akbari²

2017

Int J Cancer Manag

View full text Add to dashboard Cite

Background: Due to the high prevalence and mortality rates of esophageal cancer in some parts of the world and considering that in most patients, symptoms occur when cancer is advanced, this study aimed to compare early and late complications in three esophagectomy techniques for treatment of esophageal cancer. Methods: The present study was a descriptive research on 316 patients with esophageal cancer referring to Shohada Tajrish hospital, Tehran. The results were recorded in the research forms consisting of individual characteristics, symptoms and reasons for referring to the hospital. Findings were extracted after classification and evaluated using descriptive statistics. Results: Among 316 patients studied, 190 patients (60%) were male and 126 (40%) were female. The highest prevalence was between 40 and 60 years old. The most significant reason for referring to the hospital was dysphagia and weight loss. Among 260 patients, 72 patients (27.7%) underwent surgery by transthoracic (Ivor Lewis type) approach, 76 patients (29.2%) underwent surgery by threeincision approach (Mc Keown procedure), and 112 patients (43%) underwent surgery by Trans-Hiatal (Oringer). A total of 36 deaths occurred. 22 deaths occurred using Ivor-Lewis (61%), 10 deaths occurred using Mc Keown (27.7%) and 4 deaths occurred after Oringer (11.1%). In terms of prevalence of complications, the most common early complication was pleural effusion (11%) and the most common late complication was anastomotic stricture (17.8%). Conclusions:Complications occurred in all three surgeries. The most complications occurred using transthoracic (Ivor Lewis type) approach and the least complications occurred using Trans-Hiatal (Oringer).

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of Early and Late Complications in Three Esophagectomy Techniques

Mousavi¹,

Akbari²

2017

Int J Cancer Manag

View full text Add to dashboard Cite

show abstract

“…With esophagectomy, chylothorax most often occurs due to thoracic duct injury during mediastinal dissection (5). The overall incidence of developing a chylothorax after esophagectomy has been reported to range from 2-4% in a high-volume center (6,7). Persistent chyle loss, and its accumulation within the pleural cavity can have serious local, metabolic, and immunological effects which may have a significant impact on postoperative outcome, such as higher instances of pneumonia and arrhythmia, and a longer hospital stay after esophagectomy (8)(9)(10).…”

Section: Discussionmentioning

confidence: 99%

Localization of thoracic duct using heavily T2W MRI for intractable post-esophagectomy chylothorax—a case report

et al. 2017

View full text Add to dashboard Cite

Post-esophagectomy chylothorax is a rare yet serious complication. Herein we report the case of a patient with intractable post-esophagectomy chylothorax despite medical treatment with total parenteral nutrition and octreotide, as well as prophylactic and repeated thoracic duct mass ligation. The patient was eventually treated with localization of thoracic duct using T2-weighted magnetic resonance imaging (T2W MRI), followed by video-assisted thoracoscopic thoracic duct ligation.

show abstract

“…Injuries of the thoracic duct with chylothorax are a rare though well known complication of esophageal surgery, and are reported in 0.3 to 4 % of the patients [1]. Conservative management consists of chest tube drainage, nil per mouth and total parenteral nutrition.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, patients with persisting loss of chylous fluids are considered poor candidates for surgical interventions. This is even more important as the surgical approach to the thoracic duct may be difficult, and has a reported mortality of up to 25 % [1,3,6].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous translymphatic thoracic duct embolization for treatment of chylothorax

Schild

Hirner²

2001

Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr

View full text Add to dashboard Cite

Summary. A modified technique for transabdominal, translymphatic occlusion of the thoracic duct is described. During unilateral lymphangiography an abdominal lymph vessel was punctured with a fine needle under fluoroscopic guidance, and a 4 French access to the lymph system established. The thoracic duct was successfully embolized with coils and tissue adhesive in a patient with postoperative high output chylothorax. Chylous drainage immediately decreased after the intervention, the intercostal drain could be removed after seven days. Long term follow up over a ten months period confirmed the clinical success; the patient is still free of pleural effusions.Key words: Chylothorax ± Lymphatic system ± Intervention ± Embolization ± Treatment Pekutan-translymphatische Embolisierung der Ductus Thoracicus als Therapie für Chylothorax. Es wird eine modifizierte Technik zum transabdominellen, translymphatischen Verschluss des Ductus thoracicus vorgestellt: Während unilateralter Lymphangiographie wird ein abdominelles Lymphgefäû unter Durchleuchtungskontrolle punktiert und über einen Füh-rungsdraht koaxial eine F4-Schleuse platziert. Bei einem Patienten mit therapieresistentem postoperativen Chylothorax wurde über diesen Zugang der Ductus thoracicus distal der Verletzungsstelle mit Spiralen und Gewebekleber verschlossen. Die über eine Thoraxdrainage drainierte Chylusmenge fiel sofort nach der Intervention ab und versiegte im Verlauf, so dass die Thoraxdrainage nach sieben Tagen gezogen werden konnte. Der Patient ist mittlerweile zehn Monate frei von Pleuralerguss bzw. Chylothorax, so dass die komplikationslose Intervention auch langfristig erfolgreich war.

show abstract

Chylothorax following oesophagogastrectomy for malignant disease

Cited by 77 publications

References 17 publications

Comparison of Early and Late Complications in Three Esophagectomy Techniques

Comparison of Early and Late Complications in Three Esophagectomy Techniques

Localization of thoracic duct using heavily T2W MRI for intractable post-esophagectomy chylothorax—a case report

Percutaneous translymphatic thoracic duct embolization for treatment of chylothorax

Contact Info

Product

Resources

About